Study finds Lp(a) above 175 nmol/L raises cardiovascular risk
Updated
Updated · Medscape · Apr 30
Study finds Lp(a) above 175 nmol/L raises cardiovascular risk
15 articles · Updated · Medscape · Apr 30
Presented by Subhash Banerjee at SCAI 2026 in Montreal, the analysis of more than 20,000 NIH trial participants linked the threshold to a 31% higher risk.
After nearly four years of follow-up, the excess risk was driven by stroke and cardiovascular death, not heart attack, and was stronger in patients with existing cardiovascular disease.
Researchers said routine blood testing could identify genetically driven, symptomless risk, while aggressive LDL lowering and emerging RNA-based therapies may help reduce lifetime cardiovascular danger.
Why does this genetic cholesterol raise stroke risk but, surprisingly, not the risk of a heart attack?
A new drug class targets a risk in 1 in 5 people. Is a cardiovascular treatment revolution near?
2026 AHA/ACC Guidelines Mandate Universal Lp(a) Testing to Identify 20% at Elevated Cardiovascular Risk
Overview
The 2026 AHA/ACC guidelines mark a major advance by mandating universal one-time testing of lipoprotein(a) [Lp(a)] for all adults, recognizing it as a genetically determined risk factor that remains stable throughout life. Elevated Lp(a) levels, especially above 125 nmol/L, significantly increase the risk of heart attacks, strokes, and valve disease due to its unique structure that promotes inflammation and clotting. Because Lp(a) is resistant to standard cholesterol treatments, new therapies like pelacarsen and lepodisiran are being tested in large trials to directly lower Lp(a) by targeting its production. Early detection and family screening are now essential steps to better prevent cardiovascular disease.